title: HIV-1-related Hodgkin lymphoma in the era of combination antiretroviral therapy: incidence and evolution of CD4⁺ T-cell lymphocytes.
abstract: The risk of Hodgkin lymphoma (HL) is increased in patients infected with HIV-1. We studied the incidence and outcomes of HL, and compared CD4⁺ T-cell trajectories in HL patients and controls matched for duration of combination antiretroviral therapy (cART). A total of 40 168 adult HIV-1-infected patients (median age, 36 years; 70% male; median CD4 cell count, 234 cells/μL) from 16 European cohorts were observed during 159 133 person-years; 78 patients developed HL. The incidence was 49.0 (95% confidence interval [CI], 39.3-61.2) per 100,000 person-years, and similar on cART and not on cART (P = .96). The risk of HL declined as the most recent (time-updated) CD4 count increased: the adjusted hazard ratio comparing more than 350 with less than 50 cells/μL was 0.27 (95% CI, 0.08-0.86). Sixty-one HL cases diagnosed on cART were matched to 1652 controls: during the year before diagnosis, cases lost 98 CD4 cells (95% CI, -159 to -36 cells), whereas controls gained 35 cells (95% CI, 24-46 cells; P < .0001). The incidence of HL is not reduced by cART, and patients whose CD4 cell counts decline despite suppression of HIV-1 replication on cART may harbor HL.
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Bohlius
authors.forename: Kurt
authors.initials: K
authors.lastname: Schmidlin
authors.forename: François
authors.initials: F
authors.lastname: Boué
authors.forename: Gerd
authors.initials: G
authors.lastname: Fätkenheuer
authors.forename: Margaret
authors.initials: M
authors.lastname: May
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Caro-Murillo
authors.forename: Amanda
authors.initials: A
authors.lastname: Mocroft
authors.forename: Fabrice
authors.initials: F
authors.lastname: Bonnet
authors.forename: Gary
authors.initials: G
authors.lastname: Clifford
authors.forename: Vassilios
authors.initials: V
authors.lastname: Paparizos
authors.forename: Jose M
authors.initials: JM
authors.lastname: Miro
authors.forename: Niels
authors.initials: N
authors.lastname: Obel
authors.forename: Maria
authors.initials: M
authors.lastname: Prins
authors.forename: Geneviève
authors.initials: G
authors.lastname: Chêne
authors.forename: Matthias
authors.initials: M
authors.lastname: Egger
mesh_terms: D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D015497:HIV-1; D006689:Hodgkin Disease / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D044966:Anti-Retroviral Agents